Organization Name: | COSTCO |
NPI Number: | 1043635709 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICK MAINS (PHARMACY MANAGER) |
Mailing Address: | 1021 Woodruff Rd Greenville |
State: | SC US |
Postal Code: | 296074108 |
Phone Number: | 8642972569 |
Fax Number: | |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 03/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | 14212 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |